Causes

It is not clear why the pouches form. It may be due to a constant build up of pressure when food moves too slowly through the bowel. This pressure increases and pushes along the sidewalls of the bowel creating pouches. Digested food or stool can become trapped in one of the pouches. This leads to swelling and infection.

The following may contribute to diverticulitis:

Low-fiber diet—Fiber softens stools and makes them pass through the bowel more easily

Diagnosis

You will be asked about your symptoms and medical history. A physical and rectal exam will be done. Finding the disease early is important. The pouch can break, releasing stool into the abdomen. This is a medical emergency that requires surgery.

Your bodily fluids and waste products may be tested. This can be done with:

Blood tests

Stool sample analysis

Images may need to be taken of your bodily structures. This can be done with:

Treatment

Medications

Antibiotics and other medications are given to fight the infection. Pain medications and drugs are given to decrease the abdominal pain.

You may also be given medication to help control vomiting.

Fluids

For mild swelling, you can drink clear liquids for the first two to three days. For a more severe case, you will be admitted to the hospital, where fluids are given by IV. Antibiotics will also be given to you through IV.

Preventive Care

Changes in your diet can help prevent future attacks.

Increase the amount of fiber you eat by eating more fruits, vegetables, and whole grains

Supplement your diet with a fiber product, as advised by your doctor

Avoid laxatives and enemas

Avoid narcotic medications—they can slow down bowel movement and can cause constipation

Surgery

Surgery
to remove the section of the bowel with pouches may be advised if:

You have had multiple attacks during a two-year period

A pouch breaks and the contents spread into the abdominal cavity, which requires that the cavity be cleaned out

Surgery is also used to treat complications of diverticulitis, such as:

Abscess—occurs if the infected pouch fills with pus

Blocked bowel—scar tissue that forms and blocks movement of stool through the intestine

Fistula—occurs if the infection spreads and colon tissue attaches to another organ, such as the bladder, the uterus, or the vagina

When surgery is done on an elective basis, the surgeon will remove the part of the bowel that is diseased and connect the normal parts of the bowel back together.

When surgery is done on an emergency basis, the diseased part of the bowel will be removed. The healthy parts of the bowel will not be connected right away. Your bowel will need time to rest and heal. The upper part of the bowel will be attached to the abdominal wall. A port will allow waste to pass from the intestine to a bag outside of your body. If possible, the healthy bowel will be reconnected after 6-12 weeks.

Prevention

The following recommendations may help prevent diverticulitis by improving the movement of stool through the bowel and decreasing constipation:

Eat a balanced, high-fiber diet with plenty of fruits, vegetables, and whole grains.

Drink plenty of water each day.

Exercise regularly.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Diverticulosis and diverticulitis.
National Institute of Diabetes and Digestive and Kidney Diseases website. Available at:
http://digestive.niddk.nih.gov/ddiseases/pubs/diverticulosis/index.aspx.
Updated September 19, 2013. Accessed September 23, 2014.